Individual
DERMOT RICHARD FITZGIBBON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
UNIVERSITY OF WASHINGTON MEDICAL CTR, 1959 NE PACIFIC ST, SEATTLE, WA 98195-0001
(206) 598-4260
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
MD00032514
WA
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
MD00032514
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0230983
L&I
WA
01
—
110096408
RAILROAD MEDICARE
WA
05
—
1104901909
—
WA
01
—
9738
INTERNAL ID-MOTOR VEHICLE ID
—
Enumeration date
10/27/2006
Last updated
03/07/2012
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